HRT Shortage Crisis

In a post last week I mentioned that I’d had difficulty getting hold on my HRT. I’d been aware of issues from forums and groups that I belong to but it hadn’t been a problem for me. Research shows that in the past six months, over 84% of pharmacies had trouble getting hold of HRT prescriptions. If I hadn’t have experienced it myself I wouldn’t believe it.

When I received my new prescription I went to my local pharmacy and was told that Zumenon 1mg was out of stock. I asked the pharmacy if there was an alternative in stock that I could ask my GP for, and I was told that it was up to the GP to decide on an alternative and it was not the pharmacist’s job. I spent the next hour ringing pharmacies in my local area, twelve pharmacies later and I was still no closer to getting my HRT.

I walked back to my GP surgery and told them what had happened and asked what I should do. After a 40 minute wait I was told that I would be prescribed Elleste Solo 1mg so while I was waiting for the GP to sign the prescription, I should call around the pharmacies to see if it was in stock.

I tried five pharmacies without any success, when the receptionist came out and handed me a prescription for Elleste Solo 2mg (but to take half per day). Fortunately one of the pharmacies I had tried earlier had said that they had no 1mg tablets but did have 2mg so I didn’t have to call anymore pharmacies. Three hours, seventeen phone calls and three prescriptions later I headed to a pharmacy on the other side of town to collect my HRT.

I worked as a nurse for a long time and I remember occasional shortages of medications, but never anything on this scale. What I found the most frustrating thing was that no-one seemed to care or be able to offer solutions. I am so aware that I am fortunate enough to be able to deal with this myself but even then, I was still getting upset and worried that I wouldn’t be able to get my HRT.

I am confident and educated enough to advocate for myself with regard to my own health. I am fit, healthy and have a car so I can get myself to any pharmacy. I am financially able to drive to pharmacies, I can afford a phone with unlimited calls. I was able to take the time out my schedule to do all this. I can’t imagine having to cope with this if I suffered from anxiety or other health issues as many menopausal women do.

Last week the Government announced that they had put a ban on the export of certain drugs and medication to ensure that there was enough for the UK population. I hope this helps the situation. Please let me know if you’ve suffered or been inconvenienced by lack of HRT. It would be interesting to read how you’ve dealt with the situation.

Successfully Sleeping

Two weeks ago I posted about the trouble that I’d been having with insomnia. It was terrible but just one of many symptoms of menopause or peri menopause that women may suffer.

When I was told I needed to have a hysterectomy and my ovaries removed I knew would hit the menopause full on as soon as surgery was done. However prior to this I would’ve said that I was not in peri menopause as I’d had no hot flushes, because that’s the only sign of a menopausal women, right? WRONG. I have done a lot of reading around the subject now and I have realised that I was in perimenopause for years. I’m still complete exasperated that I had seen so many medical professionals and no-one mentioned it as a possibility. Even last month I was gently berated by GP for not researching it myself. How often are we told not to use Dr. Google as lay people?

The Make Menopause Matter Campaign aims to ensure that GPs have mandatory training in the menopause. It is ridiculous that 50% of the population will become menopausal and GPs aren’t even obliged to undertake any specific training. I was a nurse for over 20 years and I never received any training or education related to the menopause. I’ll be honest, I didn’t think the menopause was such a big issue, until it was for me.

Coincidentally, two very different approaches to menopause appeared on my Facebook timeline today, the comedic approach and the serious approach. I can relate to both of these. Compared to many women, my symptoms aren’t too severe. The insomnia has been bad but it’s been relatively short lived and it’s been treatable. I’ve had a much better week. I feel like I’m getting on top of my symptoms. I’ve switched back to oestrogen only HRT (this is saga for another post) and I was given a relaxing essential oil blend which I’ve put on my pillow. I’m not sure which one is helping with the insomnia, maybe it’s both, but long may it continue.

Five Months Since my Hysterectomy

The time has passed so quickly yet it feels like so long ago that I was in hospital and recovering from surgery. I didn’t know what to expect with my recovery. Anything from six weeks to year seemed to be the given time to recover.

I think it was during my holiday in August that I ‘forgot’ that I’d had surgery. For a relaxing beach holiday in Mexico, I participated in some reasonably adventurous activities, adventurous for me anyway.

I went down two and half miles of zip lines, which I loved. Travelling over the Mexican jungle, seeing monkeys and parrots in trees was an amazing experience. It was only when we’d finished the last line that my husband asked if I should have been doing it that I realised that I’d forgotten about having a hysterectomy. It hadn’t entered my mind and I knew that I’d completely recovered surgically.

It set the tone for the rest of my holiday and I went swimming in cenotes, which are sinkholes in the jungle. I was really apprehensive as I get a bit panicky in closed spaces and I’ve watched the film, The Descent, so I was worried about the cave like environment. Once I got into the water I was fine and started to relax.

My favourite swim of my holiday was a snorkel with sea turtles. We were taken off shore in a boat and spent about half an hour watching the fish and turtles swim beneath us. It was a very serene experience, watching the turtles glide by.

I’ve decided that I am going to look into open water swimming. I am not a good swimmer, but I’m a competent swimmer and I am improving. That’s a 2020 challenge for me. I’ve set myself a few challenges for next year already. I’ve started running again and I’ve gone back to a beginners group to focus on speed rather than distance. I am aiming for a personal best at New Year’s Day Parkrun. I’m hoping that my body will be up for that but it depends on what occurs on New Year’s Eve. After that I have 10km and half marathon targets to beat.

My holiday was strangely empowering and gave me a huge confidence boost. I asked my husband to take this photo of me in a bikini to remind future me of that time and to show myself as a confident postmenopausal woman.

Bedtime Blues

Over the past month or so I’ve been really struggling with insomnia. I’ve been able to drop off to sleep, but I’m waking up a couple of hours later and I just cannot get back to sleep.

When it first started I put the insomnia down to the hot weather, then being in a double bed (rather than a king size) on holiday, then jet lag and then I realised that this wasn’t going away.

I tried lots of things, cutting out caffeine, regular routine, mindfulness, eye masks and ear plugs. I even moved into the spare room because I was worried about waking my husband. Nothing has helped so I went to my GP.

I think the problem has only started since I started on Tibolone, I was fine when I was on Zumenon HRT. I asked the doctor if this was a side effect. She didn’t know but suggested that I could change back to Zumenon to see if it made a difference. I wanted to make an informed decision so asked what would be the risk of my endometriosis returning, as a recurrence of endometriosis was the reason why the Zumenon was changed to Tibolone. Unfortunately my GP was not equipped with this information so she’s contacting the gynaecologist who performed my hysterectomy for advice. I was disappointed but not surprised at all. GPs appear to have very little understanding of the menopause and HRT, considering half the population will have a menopause, it’s disgraceful.

While we wait for the gynaecologist’s reply, the GP suggest a sleeping tablet. For some reason, and I don’t know why, I was really reluctant to agree to it. I’m not against them, I’ve had antidepressants in the past and took those without issue. I couldn’t explain why I was reluctant but I did agree to take them on a temporary basis.

I lay in bed that night wondering why I was reluctant and I realised that I felt like a failure. Sleeping is so natural and usually so easy, and there I was not being able to do it. I needed to embrace the sleeping tablets and realise that they are a means to an end and once I have a good sleep pattern again and some answers from the gynaecologist I will be back to myself.

I saw this on Instagram this morning, from @endoandemma, such simple advice but it resonated with me and reminded me that sometimes you do need help to live normally and that’s ok.

Chillow Pillow Review

Thank you for coming back! I’ve been on a fabulous holiday and enjoying my menopausal life in Mexico. The air-conditioned rooms really helped my hot flushes, and now I’m back in England, it’s just as hot and I’m making do with fan. It’s just not the same!

However, on my return I was sent a Chillow Pillow by Live Better With in return for a review. Live Better With have a range of products designed for women going through the menopause, as well as for people with other health conditions. I particularly like that the models on the website representing menopausal women are not the typical 80 year old woman with grey hair and a red face wearing slippers and an apron.

So my Chillow Pillow arrived but it’s not a pillow. It’s a gel pad which makes it more portable, and as I’ve discovered, more versatile.

The Chillow came with set up instructions and diagrams which were really clear. It only took a few moments to pour the 2 litres of water into the Chillow to activate the gel. I might have split the water a bit but it was fine a dried off without a problem.

I left the Chillow flat for 4 hours and then removed a small amount of air by rolling it. That was it. Ready for use, no chilling necessary but the option is there if wanted.

This is where the instructions became less clear though. The Chillow has two sides, one is a grey flocked fabric, the other a mint green soft plastic. I did not know (and still don’t) which side I am meant to lie on. The instructions just said to use directly against the skin or with a pillow case. The plastic side felt cooler to touch so I rested my head on that side but inside my pillow case so my face wasn’t direct on the plastic.

The Chillow works by circulating the water inside to release the body heat and it does seem to work. My head is definitely less sweaty than usual, even on top of the plastic. It’s soft so it’s not uncomfortable. In the interests of research I slept one night with the grey side next to my head and this wasn’t as effective, and I woke up with an imprint of the valve on my face. I’ve gone back to the green side. It doesn’t stay in position particularly well, but am a fidget and sleep with lots of pillows so I probably move it without realising.

Another use for the Chillow is to cool my feet. Hot feet seem to be more of an issue for me that a hot head so I am now using the Chillow at the end of my bed and lying with my feet on it except when I kick it out bed as I fidget.

I don’t know how much these retail for so I cannot say whether I would buy one or not. It does make some difference to how I feel, but I can’t say that my sleep is improved significantly. Have you got any aids like this? What helps you to keep cool at night and minimise the night sweats?

Thank you to Live Better With for sending me Chillow Pillow to review.

HRT, UTI and All The Tablets

One thing I was not really prepared for at this stage of my recovery was the tiredness. I had read about it but I didn’t really believe it. I didn’t think after three months I would still feel tired but I do.

I have also had another urinary tract infection (UTI) which totally knocked me sideways. I had no symptoms, apart from the tiredness, and only discovered it at a routine check at the GP. Fortunately a short course of antibiotics sorted it out. I’ve been to the GP surgery eleven times this year. It’s a ridiculous amount but they’ve all been necessary.

Last month I started on hormone replacement therapy (HRT). As I’ve had my ovaries removed I was started on a daily tablet of a low dose of oestrogen. I’m not having many symptoms of menopause, mainly tiredness, hot flushes and a weird metallic taste in my mouth. Some women have it so badly, I do feel fortunate to be feeling so well. The oestrogen only HRT seemed to relieve the hot flushes and the metallic taste. I still felt tired but I wonder if that was the UTI playing a part.

Then I received a letter from my consultant who advised that I should take Tibolone, which is a different type of HRT tablet and is recommended for women who suffered with endometriosis. Tibilone reduces the chance of any endometriosis regrowing and it has partly relieved my symptoms, not as much as the first type but I need to give it a chance. My main reason for taking the HRT is to reduce the chance of osteoporosis in later life. I do think that I could probably live with my menopause symptoms but the risk of osteoporosis is a chance I don’t want to take.

I have discovered so much about HRT. There are so many types, and not just tablets but patches and gels too, different hormones for different types/stages of menopause, limited availability of certain brands, and a wide variation of when, or if, a woman should start on HRT. I’m not the person to give out advice on this so I would really recommend reading around the subject and chatting to your GP or menopause specialist.

The Hysterectomy Association

I was introduced to the Hysterectomy Association by my friend when she gave me a book called 101 Handy Hints to a Happy Hysterectomy. Coincidentally, she had a hysterectomy for similar reasons earlier this year. It’s been beneficial to us both as we’ve been able to discuss everything with no fear of offending each other with tales of pain, vaginal discharge and ‘did they stick the dressing on your pubes? How did you get it off?’.

She also knows my favourite treats.

The book was really useful, the title is self explanatory. The tips range from very sensible, such as Pelvic Floor Exercises, to the slightly more abstract Write a Poem to your Womb.

The Hysterectomy Association website is really useful too, with information regarding surgery, emotions, menopause and HRT. There’s also a discussion forum but I didn’t use that.

However, the thing I like most about the Hysterectomy Association was the series of daily emails that they send to you following surgery. The emails are sent daily for six weeks and tie into the appropriate stage of your recovery. I received emails about constipation relief, the 1 in 3 walking challenge, driving and HRT amongst many other things. I found it reassuring to read the daily emails and compare them to how I was progressing.

They also have a fundraising campaign called 5000 Fivers, I have donated to show my appreciation and to help to keep the Association going.